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01-12-2008 | Original

Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients

Authors: Catharina F. M. Linssen, Jan A. Jacobs, Foekje F. Stelma, Walther N. K. A. van Mook, Peter Terporten, Cornelis Vink, Marjolein Drent, Cathrien A. Bruggeman, Annick Smismans

Published in: Intensive Care Medicine | Issue 12/2008

Abstract

Objective

To evaluate the relationship between the HSV-1 and -2 loads in BAL fluid (BALF) and clinical outcome.

Design

Retrospective study.

Setting

The general intensive care unit of the University Hospital Maastricht.

Patients

Five hundred and twenty-one BALF samples from 462 patients were included. Patients were divided into three groups; (1) patients admitted to the hospital <48 h before lavage (Community), (2) patients admitted to the ICU >48 h before lavage (ICU) and (3) the remaining patients (non-ICU group).

Interventions

No additional interventions were conducted.

Measurements and results

HSV-1 and HSV-2 loads were determined by real-time polymerase chain reaction (PCR). HSV-1 DNA was detected in 4.3% (4/92) of samples in the community group, 15% (18/121) in the non-ICU group and in 32% (99/308) of the ICU group. In the age group <50 years HSV-1 DNA was less frequently isolated compared to the age group ≥50 years (16/129 (12%) versus 187/376 (25%), respectively, OR = 2.6; P < 0.001). HSV-1 loads of >10⁵ genome equivalents (ge)/ml were associated with an increased 14-day in-hospital mortality compared to patients with a HSV-1 load ≤10⁵ ge/ml in BALF (41 vs. 20%, respectively, P = 0.001). HSV-1 pneumonia was histologically proven in two patients with a HSV-1 load exceeding 10⁵ ge/ml.

Conclusions

HSV-1 occurred more in critically ill patients and high loads in BALF were associated with an increased mortality. The higher mortality observed in patients with HSV-1 load >10⁵ ge/ml enforces its clinical relevance and necessitates to start randomized medical intervention studies.

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Title: Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients
Authors: Catharina F. M. Linssen
Jan A. Jacobs
Foekje F. Stelma
Walther N. K. A. van Mook
Peter Terporten
Cornelis Vink
Marjolein Drent
Cathrien A. Bruggeman
Annick Smismans
Publication date: 01-12-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1231-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Herpes simplex virus load in bronchoalveolar lavage fluid is related to poor outcome in critically ill patients

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusions

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